Black Kids at Greater Risk for Food Allergies

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This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Black children were more than three and a half times as likely to be sensitized to one or more food allergens than white children.

Point out that there were no significant differences between races for environmental allergen sensitivity.

SAN ANTONIO -- Black children were more than three and a half times as likely to be sensitized to one or more food allergens than white children, researchers reported here.

A birth cohort of African-American and non-Hispanic white children showed black children had increased chances of developing sensitivity to one or more food allergens by age 2 (odds ratio 3.65, 95% CI 1.84 to 7.25), according to Haejin Kim, MD of the Henry Ford Hospital in Detroit, Mich., and colleagues.

However, there were no significant differences between races for environmental allergen sensitivity (OR 1.31, 95% CI 0.74 to 2.34), Kim said at a poster session during the meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI).

Kim noted that prior research had shown conflicting results in racial allergen sensitivity. Most notably, sensitivity to an allergen did not immediately imply that a child would have a symptomatic reaction to a given allergen, she explained.

The researchers tested differences in food and environmental allergen sensitivity by race through the WHEALS (Wayne County Health Environment Atopy and Asthma Longitudinal Study) birth cohort.

The sample included 543 children, age 2, with 388 black children. Parents were interviewed for their own allergic history of diagnosed hay fever, nasal allergies, and allergic rhinitis. Race was self-reported.

Children were skin tested with seven aeroallergens and three food allergens. These included:

Alternaria alternata

Dust mite

Short ragweed

Dog

Cat

German cockroach

Timothy grass

Egg white

Peanut

Milk

Confounders included sex, birth order, and parental history of atopy.

Of the sampled children, 71 had a positive skin test for at least one aeroallergen and 88 had a positive skin test for at least one food allergen.

African-American children had nearly four-fold odds of having food allergen sensitivity compared with white children (OR 3.65, 95% CI 1.84 to 7.25, P<0.001). These odds were especially elevated among children born to atopic parents, where odds were increased more than six-fold (OR 6.17, 95% CI 1.79 to 21.2, P=0.004).

Rates of aeroallergy were similar between groups (13.9% of black children versus 11% of white children) and the OR for aeroallergen sensitivity did not differ significantly (P=0.36).

In comparisons of white and black children for aeroallergen, outcomes did not differ by sex or birth order, but there was a trend for children of atopic parents to a nearly 2.5-fold risk of aeroallergen sensitization among black children (OR 2.45, 95% CI 0.87 to 6.87, P=0.08).

There was also a greater risk for food allergen sensitization for nonfirst born black children (OR 4.16, 95% CI 1.74 to 9.91, P=0.001) and a nearly three-fold risk for children whose parents were not atopic (OR 2.82, 95% CI 1.15 to 6.92, P=0.023) when compared with white children. There was also a three-fold trend for food allergen sensitivity among firstborn black children compared with firstborn white children (P=0.066).

In an interview with MedPage Today, Kim noted that because food allergen sensitization does not always imply an intolerance to a food, there was no examination of clinical outcomes for this disparity in food sensitivity.

"This is just one piece of the puzzle, the same is true for aeroallergens ... this is something we need to explore further," she said.

She added that the take-home message of the study was that blacks are more likely to be sensitive to food allergens regardless of gender, birth order, or history of diagnosed allergies in parents. "[Black children] are just at higher risk," she said.

She noted that the study was limited by the reliance on relying on a clinician's report of allergic rhinitis.

The study was funded by the Henry Ford Hospital and the National Institute of Allergy and Infectious Diseases.

The authors declared no conflicts of interest.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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